The objective of this proposal is to provide in-depth research training in cutting edge (and emerging) areas of biomedical science related to anesthesiology and perioperative medicine, including critical care. The University of Washington (UW) Department of Anesthesiology has a long history of academic excellence and clinical innovation. This new program application aims to reinstate one of the longest running training programs in anesthesiology (35 year history). After a decade of space constraints, UW is rebuilding academic anesthesiology in significant ways, complete with research space commitments (total 24,000 square feet) and resources required to add 5-6 well funded mid- senior level physician-scientist and research scientist faculty. This proposal is designed to capitalize on these new departmental initiatives and, importantly, the existing outstanding research environment at UW in order to train the next generation of anesthesiology physician scientists. Trainees will be sought from a national pool of candidates. The structure of this program involves 2-3 years of research training closely supervised by NIH-funded UW faculty mentors on projects ranging from laboratory-based science to more translational and clinical projects;3-4 new fellows will be enrolled each year who have completed anesthesiology residencies and relevant clinical subspecialty training (so fellows will be 5-6 years post-MD). Five major research areas relevant to perioperative medicine are emphasized. These include (alphabetically): 1) cardiovascular-pulmonary biology &regenerative medicine, 2) clinical outcomes research &epidemiology, 3) genome sciences &bioinformatics, 4) neurosciences, and 5) pharmacology. Goals of the program include acquisition of fundamental research skills, mastery of the relevant literature, understanding responsible conduct of research including IRB/IACUC approvals, ability to summarize research findings in manuscript form and grant applications, and presenting findings in public settings such as journal clubs and national scientific meetings. Trainee progress is monitored regularly by an individualized fellow-specific review committee (meeting with mentor and fellow quarterly in year 1, semi-annually thereafter) with summary findings reported to the departmental training grant executive committee responsible for accepting/hiring fellows and following their progress. In addition, a UW-wide external scientific oversight board meets yearly to offer advice to the executive committee on all aspects of the training program. The overall intent of the program is to develop the next generation of perioperative physician scientists and academicians. Relevance: During surgery and critical illness, patients reproducibly experience stress to the limits of human physiology;this is a unique period where human tissue samples can be obtained ethically as well. Mechanistic basic science, translational, and clinical studies targeting perioperative physiology provide important insights broadly relevant across medicine, a fact recently appreciated by many medical specialties. With the aging population, developing physician scientists capable of tackling scientific questions in this important arena of medicine should make care of surgery, trauma, and intensive care patients safer.